People to watch in 2011: Marilyn Kawamura

CEO, Kaiser Permanente Mid-Atlantic

Marilyn Kawamura, the veteran CEO of Kaiser Permanente’s mid-Atlantic region, has seen good times and bad in her 11 years atop the health maintenance organization.

But 2011 will be a particularly important year, the year that will test a strategic plan implemented four years earlier under her watch.

In January, Kaiser will open the doors of its 200,000-square foot Capitol Hill Medical Office near Union Station in D.C. Later in the year, it will begin construction on three major suburban locations, in McLean, Gaithersburg and Largo. Other real estate development continues across Kaiser’s service territory, from Northern Virginia to Baltimore.

Kawamura and her bosses at the nonprofit insurer’s Oakland, Calif., headquarters are betting on the popularity of the Kaiser model — covering only care provided by Kaiser-employed doctors and nurses, or at a limited range of contractually tied hospitals.

It’s a model widely rejected by many health care consumers in the 1990s as the three-letter abbreviation “HMO” became a dirty word after horror stories about insurance functionaries getting in between patients and doctors.

But times have changed. Employers’ health care premiums continue to rise much more quickly than inflation, and some evidence indicates employers are reconsidering the trade-off that enabled employees to see virtually any doctor they wanted in exchange for higher premiums.

Kawamura says Kaiser believes the Washington area — full of mobile, high-earning professionals — could be a growth market for the insurer because of the appeal of lower prices, well-managed, one-stop shop clinics and high-end electronic medical records.

She may be right. Washington-area employers are twice as likely to offer HMOs as an insurance option, according to a November survey by Mercer Health & Benefits LLC.

But the question for Kaiser is whether employers and employees, given a choice, will choose its plan over the more traditional plans of competitors such as market leader CareFirst BlueCross BlueShield. Next year could provide some early answers.